Ischemic Conditioning to Promote Microvascular Resiliency in Frail Individuals
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Ischemic Conditioning.
- Who it may be relevant to
- Registry conditions: Aging, Fragility, Endothelial Dysfunction. Basic parameters: 65 years — 85 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- United States
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Overview
The goal of this clinical trial is to see how small blood vessels respond to the stress of high intensity exercise, and if a safe and simple intervention called ischemic conditioning can protect blood vessels from the stress of exercise. Participants will come in for 3 study visits and get home-based ischemic conditioning. At Study Visit 1, participants will be assessed for their frailty and physical function. Afterwards, they will perform an exercise test. At Study Visit 2, patients will undergo 2 microvascular assessments, perform a high-intensity exercise, then undergo the same 2 microvascular assessments again. Participants will be given a handheld sphygmomanometer and a blood pressure cuff to take home. Depending on which group the participants get randomized into, participants will place the blood pressure cuff around their non-dominant upper arm and inflate to either a low or high pressure for 2 weeks at home. Participants will repeat the same steps in Study Visit 2 for Study Visit 3. In addition, participants will also be assessed for their frailty and physical function.
Detailed description
In elderly individuals the small blood vessels that regulate blood flow to organs and other tissues can become damaged when they are exposed to stress, which can lead to complications following stressful events like surgery. In this study we will examine how these blood vessels respond to the stress of high intensity exercise, and if a safe and simple intervention called ischemic conditioning can increase resiliency of these vessels.
Our previous work showed that conditioned athletes are protected from the stress of a single, high intensity exercise bout whereas non-athletes are not. Others have shown that elderly individuals have reduced large artery function following the high intensity exercise. This study will be the first to examine how the small blood vessels respond to this stress in the elderly. Participants will be asked to come in for 3 study visits.
Study Visit 1
1. Complete assessments on frailty and physical function 2. Complete an exercise test using either a total body recumbent stepper or a bicycle and pedal in a seated position
Study Visit 2
1. Undergo a blood draw to measure plasma sphingolipids 2. Have a CytoCam device take images of small vessels inside their mouth 3. Be assessed by the Laser Doppler Flowmeter while small doses of a vasodilator called acetylcholine are infused into the skin and the local temperature increases 4. Complete a high-intensity interval exercise on a bicycle or an elliptical machine 5. Have a CytoCam device take images of small vessels inside their mouth 6. Be assessed by the Laser Doppler Flowmeter while small doses of a vasodilator called acetylcholine are infused into the skin and the local temperature increases
Home-based Ischemic Conditioning
1. Get a handheld sphygmomanometer and a blood pressure cuff to take home. 2. Depending on which group the participants get randomized into, participants will place blood pressure cuff around non-dominant upper arm and inflate to either a low or high pressure. 3. This intervention will be completed 5 times a day for 2 weeks
Visit 3
1. Undergo a blood draw to measure plasma sphingolipids 2. Have a CytoCam device take images of small vessels inside their mouth 3. Be assessed by the Laser Doppler Flowmeter while small doses of a vasodilator called acetylcholine are infused into the skin and the local temperature increases 4. Complete assessments on frailty and physical function 5. Complete an exercise test using either a total body recumbent stepper or a bicycle and pedal in a seated position 6. Complete a high-intensity interval exercise on a bicycle or an elliptical machine 7. Have a CytoCam device take images of small vessels inside their mouth 8. Be assessed by the Laser Doppler Flowmeter while small doses of a vasodilator called acetylcholine are infused into the skin and the local temperature increases
Interventions
- Other Ischemic Conditioning
We will use a randomized block design to randomize individuals into either Ischemic Conditioning-Low or Ischemic Conditioning-High group using an online randomizer. A handheld sphygmomanometer and blood pressure cuff will be given to study participants. For the Ischemic Conditioning-High group participants, while sitting, the cuff will be placed around the non-dominant upper arm and inflated to 225 mmHg for 5 min, then released for a 5-min recovery period. A 5-min inflation period is most used.
Primary outcome measures
- Change in Acetylcholine-mediated dilation [Time frame: 2 hours]
- Change in Perfused Vessel Density [Time frame: 0.5 hours]
Eligibility criteria
Inclusion criteria
- Women and men ages 65-85 years of age
Exclusion criteria
- Myocardial infarction in last 6 months
- morbid obesity (BMI >40)
- heart failure
- uncontrolled hypertension
- other condition that precludes high intensity exercise (ex, neurological disorder, acute systemic infection)
- history of blood clots in the extremities
- any condition in which compression of the arm or transient ischemia is contraindicated (e.g., wounds in the arm).
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: Yes
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Quadruple blind
- Primary purpose
- Treatment
Study locations
United States · 1 center
- Froedtert Hospital — Wauwatosa
Identifiers
NCT: NCT05808686 · PRO00046569